Apparatus for plastic surgery



March 16, 1954 1. TOUSON APPARATUS FOR PLASTIC SURGERY 3 Sheets-Sheet 1Filed Nov. 10, 1952 INVENTOR. BY ,4

March 16, 1954 l. TOUSQN APPARATUS FOR PLASTIC SURGERY 3 Sheets-Sheet 2Filed Nov. 10, 1952 I INVENTOR. ZMCELJ BY March 16, 1954 1. TOUSON2,672,146 APPARATUS FOR PLASTIC SURGERY Filed Nov. 10, 1952 3Sheets-Sheet 3 INVENTOR. BY qz'wwam discomfort to the patient. willfbe'providedrmth adjusting means allowing Patented Mar. 16, 1954 UNITEDSTATES PATENT OFFICE 2,672,146 APPARATUS FOR. PLASTIC SURGERY IsaacTouson, Buenos Aires, Argentina Application November 10, 1952, SerialNo. 319,691

8 Claims.

.This invention relates to apparatus for use in surgery, and moreparticularly in plastic surgery. When it is necessary to restore theloss of nasal substance in the region of the wings and lobes, it ispossible to resort to the auricular substance of the same patient andcarry out a sort of transplantation. However, certain operatoryconditions should be met so as to deal with the behaviour of thetissues, and in order to obtain the union of the transplanted auriculartissue with the previously quickened borders of the loss of nasalsubstance, it is necessary, in order to avoid the necrosis of theauricular flesh, to join same before trimming, for example with thepatients thumb, and to only remove the thumb from the tissue after thelatter has become joined to the edges of the loss of nasal substance.

In order-toeifect digito-auricular and nasoauricular unions the merejuxtaposition and suture of the parts is not sumcient, and it isnecessary to avoid displacements and separations thereof, which wouldunavoidably occur, even when the patients hand is immobilized throughoutthe time required to complete the process of uniting the parts.

Prior toithis invention, such fastening of the hand has been donethrough the use of bandages and strapsamethod which leaves the patientina very uncomfortable condition, particularly during the step ofnaso-auricularsuture. On the other hand, in view of the long time duringwhich the patient must keep the bandages on, it is practicallyimpossible to use thesame bandages and straps again, so that a materialwhich must be specially prepared is lost each time. Also, it is obviousthat a bandage cannot secure the absolute immobilization of the tip ofthe thumb, either during the digito-auricular step or'the naso-auricularstep, with the consequent dangerfailure of the operat'on, at least fromthe a'esthetical point of view. Finally, during the 'na'so-auricularsuture step the face and the nasal partition are the only bearing pointsfor the patients hand and thumb, which besides being highlyuncomfortable could cause the occlusion of the nasal fossa uponcompletion of the nascauricular suture, thus requiring a rectifyingoperation when circumstances permit.

Therefore, the'object of this invention is to provide an apparatusafiording clamping surfaces and supporting members suitably arranged andallowing the immobilization of the thumb and hand in a very'simplemanner and with minimum Also, the apparatus an almost universal usethereof, and due to its mechanical construction it can be made ofmaterials which may be readily rendered sanitary so as to allow the usethereof in an indefinite number of cases. On the other hand, as will beseen hereinafter, the novel apparatus allows the efficient airing of thepatients head and transfers the supporting pressures from the head tothe shoulders.

Generally, the novel apparatus for plastic surgery comprises a shoulderfitting member or yoke, a central support for a head clamping ring and apair of lateral supports extending from said shoulder fitting member andcapable of being adjustably attached to the ends of a hand supportinghalf hoop and of a jaw support, there being provided also a thumb restcapable of being adjustably secured to said half hoop, and securingelements adjustably secured to the shoulder fitting member.

In order that the invention may be more clearly understood, a preferredembodiment thereof has been illustrated by way of example in theaccompanying drawings, wherein:

Fig. 1 is a perspective view of an embodiment of a plastic surgeryapparatus in accordance with this invention.

Fig. 2 is a side view of the hand supporting half hoop thereof.

Fig. 3 is a perspective view of the half hoop supporting plate.

Fig. 4 is an end view of the thumb rest.

Fig. 5 is a plan view of the thumb rest shown in Fig. 4.

Fig. 6 is a forward end view of the jaw ring.

Fig. '7 is a plan view of the ring shown in Fig. 6.

Fig. 8 is a side view of the jaw ring; and

Figs. 9 and 10 are views showing the back and palm sides of a gauntletconstituting an accessory of the apparatus of this invention.

Referring first to Fig. 1, it will be seen that the apparatus of thisinvention comprises a shoulder fitting member or yoke I including a backportion 2 and a pair of suitably shaped shoulder ends 3, there beingprovided also a pair of auxiliary securing elements 4 secured eitherpermanently or detachably to said yoke. A main support 5 extending fromthe central portion of said yoke 1 supports a head clamping ring 6designed to surround the patients head. While this ring 6 may beintegral with the support 5, it is preferred to form same as a separatemember and connect it in an adjustable manner to said support, so as toallow a graduation of the spacing between the ring and the yoke. Forthis purpose, the support is formed with a slot I engaged by ascrew-threaded pin 8 secured to the ring 6, preferably in a permanentmanner, and capable of receiving a washer 9 and a wingnut iiiconstituting the means for securing the head clamping ring 5 withrespect to the main support 5. Diametrically opposite the support 5,said ring 6 is divided and provided with a pair of projections 5! formedwith holes l2 through which a tape or cord (not shown) may be passed forthe purpose of fastening the ring to the patients head by tying.

Extending from each shoulder end 3, there is provided a lateral supportl3 having a longitudinal slot it capable of receiving fastening meansfor fixing a supporting half hoop l5 in a desired position, said lateralsupport 13 serving also as a complementary fixing point for the headclamping ring as an anchoring point for a jaw support It. By means ofthis construction it is possible to adjust the main parts as to heightand also, as regards the half hoop and jaw support, as to the spacingfrom the main support 5. By using the lateral supports l3 for the threepurposes indicated above, it is possible to reduce to a minimum thenumber of parts and therefore the weight of the apparatus, whileretaining the universal applicability thereof.

Suitable fastening means are provided for the supplementary side holdingof the head clamping ring 5, which may for example take the form of abolt ll, washer l8 and wing-nut it.

By inspecting Figs. 1, 2 and 3, it will be seen that the half hoop l5comprises a supporting portion approximately semi-circular and frustoconical in shape, as clearly shown in Fig. 2, this supporting portionhavin' a lon itudinal slot 2i. The half hoop [5 comprises also a pair offastening ends 22 preferably somewhat wider than the supporting portionand provided with a pair of narrow slots 23 extending parallelly ateither side of a wider fastening slot 24 extending longitudinally of thefastening ends 22.

As shown in Fig. l, the half hoop i5 is adjustably secured at thefastening ends 22 thereof to the lateral support l3 by means of a bolt25 having an enlarged head 25 seated against the inner face of thecorresponding lateral support l3, said bolt 25 being passed throu h thesupport slot Hi and through the fastening 24 at the supporting end 22 ofthe half hoop [5. An immobilizing plate 2! is applied against the outerface of the supporting end 22. The construction of this place 2? is moreclearly shown in Fig. 3 from which it will be seen that it is generallyrectangular in shape and is cut away and bent so as to provide a pair oftongues 28 parallel to each other and located at each side of a centralopening 25 designed for fitting over the bolt 25, so as to engage thenarrow slots 23 in the fastening end 22. By cutting and bending thetongues 28, arms 32 are formed at each side thereof, the free ends ofwhich are flanged as indicated at 3| so as to extend in the samedirection as the tongues 28, the assembly being proportioned so that theflanges 3! will fit on the upper and lower edges 32 and 33 (Fig. 2). Theplate 2'! is secured by means of a wing-nut 36 screwed onto the bolt 25,whereby the plate 2? will cooperate with the respective lateral supportit in securing the fastening ends 22 of ring 55 and also in preventingthe oscillation thereof, since the tongues 28 are of sufficient lengthto enter the longitudinal slot [4 in the side supports it after havingbeen slot whereas the tongues 28 are arranged :1

thumb passed through the narrow slots 23 in the fastening ends 22, asclearly seen at the right-hand portion of Fig. 1.

The slot 2! in the half hoop serves for fastening a finger rest at anyperipheral point of the half hoop, the construction of said finger restbeing clearly shown in Figs. 1, 4 and 5. It comprises a supportingcurved portion 35, suitably shaped so as to allow the resting thereon ofa finger, preferably the thumb, and a fastening projection 5'! having ahole 38 for allowing the passage of a screw 39 by means of which and awing-nut 4f! the thumb rest may be secured to the half hoop, as shown inFig. 1. Obviously, a

rest for each hand will be provided, although in practice only one willbe used at a time, but it is necessary to consider the possibility ofoperating on. both nose wings.

Considering now Figs. 1, 6, '7 and 3 it will be seen that the apparatusincludes also a jaw support 15 comprising a concave portion 4| designedfor supporting the patients lower jaw, and divergent arms 42 which mayhave an angular shape and are preferably inclined away from the generalplane of the concave portion, so that the ends of arms 42 having a deepnotch 43 may be fastened, for example by means of a bolt 44 and awing-nut 45 (see Fig. 1) to the lateral supports l3 below the fasteningends 22 of the half hoop I5. For reasons of safety, the free ends ofarms 42 are flanged as indicated at 46, so as to provide abutmentsadjusting against the rear edges of lateral supports l3.

Inasmuch as the effective lever resulting from fastening the jaw support[6 to the lateral arms 13 is important, if necessary the free end ofsaid jaw support represented by the concave portion may be reinforced bymeans of a sling-like piece made of leather, linen or other suitablematerial, which will be passed under the concave portion and the ends ofwhich may be connected to the head clamping ring 6; for this purpose,the ring 6 is provided with pins 48. Also, other pins 49 may be providedon the head clamping ring for holding a support for the patients arm.The sling-like element for the jaw has been indicated at 41 in Figs. 1and 8.

The apparatus is completed with an accessory shown in Figs. 9 and 10,having the form of a gauntlet and serving for fastening the patientshand to the half hoop 15, for which purpose the palm face of thegauntlet 50 is provided with a screw 5| with a corresponding wing-nut52, the back face of the gauntlet being provided with eyelets 53 and acord 54 for fastening same. As in the case of the thumb rest 35, agauntlet will be provided for each hand.

It will be understood that the parts of the apparatus, and particularlythe head clamping ring, the yoke and the concave portion of the jawsupport may be lined with resilient material such as sponge, felt or thelike, so as to increase the comfort to the patient, this possibilityhaving been indicated only for the head clamping ring at 55 in Fig. 1.

When it is found advisable to resort to rhinoplasty, for the first stepthe apparatus is placed on the patients shoulder with the head clampingring around the head, making the necessary adjustments as to height.

The gauntlet 55 is applied to the corresponding hand and connectedloosely to the half hoop l5 by means of the screw 5| and wing-nut 52,the half hoop being adjusted to a suitable position with the aid of thefastening system comprising the ends 22, the immobilizing plates 21and-wing nuts 34,; the jaw support lfifbelng also placed in a positionwhich is comfortable to the patient; wherein it is fixed by means of thewing-nuts 45. The fastened hand is then moved to the half hoop I5, to aposition suitable for the surgical operation necessary for causing thedigito-auricular adhesion, whereupon the hand if fixed definitely in thedesired position by means of the wing-nut 40 (Fig. 4). The patient isthus arranged comfortably for the time required for the digito-auricularsuture, with the assurance that the finger (thumb) cannot be moved fromits proper position.

After the required period of time, the second rhinoplasty step will becarried out, said step comprising the sectioning of the auriculartissue, suture of the borders of the notch in the external ear andnaso-auricular suture. For this purpose, the wing-nut 40 is loosened soas to allow the movement of the corresponding hand along the half hoopl5 at the proper time, in order to bring th finger with the auriculartissue to the position required for the naso-auricular suture, in whichposition it will be fastened again by tightening the wing-nut 60. Withthe same assurance as before that the hand cannot move, it will, with afair amount of comfort to the patient, be held in place during all thetime necessary for joining the tissue to the edges of the nasalsubstance loss.

Once the rhinoplasty is completed, the apparatus may be easily removedfrom the patient and after separatin the interposing pads, it may becleaned and sterilized. The apparatus may thus serve for anotherpatient. since it may be readily adjusted to the physicalcharacteristics of the latter, as explained above.

It is evident that several changes, modifications and/or alterationswill occur to those skilled in the art, in carrying out the invention,without departing from the scope thereof as defined in the appendedclaims.

I claim:

1. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, a head clampingring mounted on said central support, a lateral support extending fromsaid member on either side of said central support, a hand supportinghalf hoop having ends adjustably secured each to a respective lateralsupport, a jaw support having ends adjustably secured each to arespective lateral support, a thumb rest adjustably mounted on said halfhoop and securing elements adjustably secured to said shoulder fittingmember.

2. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, a head clampingring mounted on said central support, a lateral support extending fromsaid member on either side of said central support, a hand supportinghalf hoop of frusto-conical shape having ends adjustably secured each toa respective lateral support, a jaw support having ends adjustablysecured each to a respective lateral support, a thumb rest adjustablymounted on said half hoop and securing elements adjustably secured tosaid shoulder fitting memher.

3. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, a head clampingring mounted on said central support, a lateral support extending fromsaid meme her on eitherside of said central support, a'; handsupportinghalf hoop slotted lengthwise todefine a, longitudinal slot, said halfhoophavn end a iust lr s cured each to a s c ive late a u port, a aw sur h ving, ends a r justab ly secured each to a respectivelateral sup,port, a thumb rest including a fixing screw, said thumb rest beingadjustably mounted on said half hoop with said fixing screw extending hrh aid lo i d na ot and c in e ements adjustably' secured to saidshoulder fitting member.

4. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, a head clampingring mounted on said central support, a lateral support extending fromsaid member on either side of said central support, each lateral supportbeing slotted to define an adjustment slot, a hand supporting half hoophaving ends, each end being dotted to define a central slot and alateral slot on either side of said central slot said slots extendinglengthwise of said half hoop ends a fixing plate having a pair of offsetlugs of a size to extend through said lateral slots and through saidadjustment slot, said fixing plate being perforated to provide a bolthole, bolt means for locking the ends of said half hoop to respectivelateral supports, said bolt means being of a size to pass through saidbolt hole said central solt and said adjustment slot, a jaw supporthaving ends adjustably secured each to a respective lateral support, atumb rest adjustably mounted on said half hoop and securing elementsiadjustably secured to said shoulder fitting member.

5. An apparatus for use in plastic surgery according to claim 4 in whichsaid fixing plate comprises oppositely disposed ofiset lugs and agripping arm extending from said plate on either side of each lug, theends of said gripping arms being bent over for gripping the edges ofsaid half hoop.

6. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, said centralsupport being slotted to define a lengthwise extending slot, a headclamping ring including a fixing screw of a size to pass through saidlengthwise extending slot and means for said fixing screw for securingsaid head clamping ring in adjusted position to said central support, alateral support extending from said member on either side of saidcentral support, a hand supporting half hoop having ends adjustablysecured each to a respective lateral support, a jaw support having endsadjustably secured each to a respective lateral support, a thumb restadjustably mounted on said half hoop and securing elements adjustablysecured to said shoulder fitting member.

7. An apparatus for use in plastic surgery according to claim 6, inwhich each lateral support is slotted to define an adjustment slot andsaid head clamping ring further includes screw threaded fixing means ofa size to pass through said adjustment slots.

8. An apparatus for use in plastic surgery comprising a shoulder fittingmember, a central support extending from said member, a head clampingring mounted on said central support a lateral support extending fromsaid member on either side of said central support, a hand sup portinghalf hoop having ends, each end being recessed to provide a pair ofspaced tongues defining between them a deep notch, the ends of saidtongues being bent over to form stops for engaging the edges of saidlateral supports nearest said central support, each lateral supportbeing slotted lengthwise to define an adjustment slot, bolt means of asize to pass through said deep notches and said adjustment slots foradjustably securing said half hoop to said lateral supports, a jawsupport having ends adjustably secured each to a respective lateralsupport a thumb rest adjustably mounted on said half loop and securingelements adjustably secured to said shoulder fitting member.

ISAAC TOUSON.

References Cited in the file of this patent UNITED STATES PATENTS 10Number Name Date 1,301,276 Kroetz Apr. 22, 1919 1,803,556 Nugent May 5,1931

